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OBJECTIVE: Lifestyle interventions are effective, but those delivered via in-person group meetings have poor scalability and reach. Research is needed to establish if remotely delivered lifestyle interventions are non-inferior to in-person delivered lifestyle interventions. METHODS: We conducted a randomized non-inferiority trial (N = 329) to compare a lifestyle intervention delivered remotely and asynchronously via an online social network (Get Social condition) to one delivered via in-person groups (Traditional condition). We hypothesized that the Get Social condition would result in a mean percent weight loss at 12 months that was not inferior to the Traditional condition. Additional outcomes included intervention delivery costs per pound lost and acceptability (e.g., convenience, support, modality preferences). RESULTS: At 12 months, no significant difference in percent weight change was observed between the Get Social and Traditional conditions (2.7% vs. 3.7%, p = 0.17) however, criteria for non-inferiority were not met. The Get Social condition costs $21.45 per pound lost versus $26.24 for the Traditional condition. A greater percentage of Get Social condition participants rated participation as convenient (65% vs 44%; p = 0.001). CONCLUSIONS: Results revealed a remotely-delivered asynchronous lifestyle intervention resulted in slightly less weight loss than an in-person version but may be more economical and convenient. TRIAL REGISTRATION: ClinicalTrials.gov NCT02646618; https://clinicaltrials.gov/ct2/show/NCT02646618 .
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Few weight loss and weight loss maintenance interventions are tailored to include factors demonstrated to predict the user's behavior. Establishing the feasibility and acceptability of such interventions is crucial. The aim of this study was to assess the acceptability and feasibility of a theory-based, tailored, online-delivered weight loss and weight loss maintenance intervention (Choosing Health). We conducted a mixed methods process evaluation of the Choosing Health tailored intervention, nested in a randomized controlled trial (N = 288) with an embedded N-of-1 study, investigating participants' and implementers' experiences related to intervention context, implementation, and mechanisms of impact. Measures included: (i) surveys, (ii) data-prompted interviews (DPIs) with study participants, (iii) semi-structured interviews with implementers, and (iv) intervention access and engagement data. Five themes described the acceptability of the intervention to participants: (i) monitoring behavior change and personal progress to better understand the weight management process, (ii) working collaboratively with the intervention implementers to achieve participants' goals, (iii) perceived benefits of non-judgmental and problem-solving tone of the intervention, (iv) changes in personal perception of the weight management process due to intervention tailoring, and (v) insufficient intervention content tailoring. The intervention delivery was feasible, however, emails and text messages differed in terms of accessibility and resources required to deliver the content. The use of Ecological Momentary Assessment as a technique to gather personal data for further tailoring was acceptable, and facilitated behavior change monitoring. Personalization of the intervention content above and beyond domain-specific issues, for example, by addressing participants' social roles may better match their needs. Support from the implementers and feedback on body composition changes may increase participants' engagement.
People with overweight and obesity can benefit from participating in behavior change programs that are individually adjusted to participants' psychological characteristics. It is important to provide knowledge of how to design acceptable and feasible, widely accessible, sustainable tailored interventions for weight loss, and weight loss maintenance. We designed Choosing Healtha tailored intervention that matched intervention content to psychological factors that were demonstrated to influence each participant's behavior. This study assessed whether the Choosing Health program was acceptable and feasible from the point of view of program participants and people who worked directly with the participants. The intervention tailoring supported participants in changing the way they thought about the weight loss process, and regular tailored messages served as a cue to maintain healthy habits. However, tailoring based on psychological characteristics was insufficient for many participants, as they would have preferred more personalized content. We provide guidance on good practices to gather data for tailored support, monitor behavior change progress, and for communicating with participants, to improve the acceptability of tailored interventions. We also compare how acceptable participants found methods of intervention delivery (SMS messages, emails, handbook) to advise which methods are the most acceptable and preferred by participants.
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Estudos de Viabilidade , Aceitação pelo Paciente de Cuidados de Saúde , Redução de Peso , Programas de Redução de Peso , Humanos , Feminino , Masculino , Programas de Redução de Peso/métodos , Pessoa de Meia-Idade , Adulto , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Intervenção Baseada em Internet , Manutenção do Peso Corporal , Internet , Comportamentos Relacionados com a SaúdeRESUMO
Background: Barriers to attending in-person lifestyle interventions are common during pregnancy. The majority of young adults use Instagram, and pregnancy-related content abounds on this social media platform. The aims of this study were to assess interest in an Instagram-delivered gestational weight gain (GWG) intervention, examine characteristics associated with program interest, describe interest in specific program components, and to explore perceived advantages of and concerns about the proposed intervention. Methods: English-speaking pregnant women with pre-pregnancy overweight or obesity in the US who use Instagram completed a cross-sectional online survey (N=229). Participants reported interest in a proposed Instagram-delivered GWG intervention (very/quite a bit versus somewhat/a little bit/not at all interested), demographics, and Instagram use habits. Characteristics associated with program interest were examined using logistic regression models. Responses to open-ended questions about program likes and concerns were content-analyzed. Results: Thirty-four percent were very or quite a bit interested in an Instagram-delivered GWG intervention, and women with children, those who were more extraverted, and those with greater engagement on Instagram were more likely to report interest. Among participants with high program interest, 63-95% were interested in specific intervention components and 52-82% were willing to engage in different aspects of the intervention. Participants liked the potential for information, peer support, convenience, and accountability, but reported concerns about privacy/confidentiality, social pressure, time required, and negative psychological consequences. Conclusions: Fostering a positive, supportive group culture may be key to leveraging Instagram to deliver a GWG intervention.
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OBJECTIVE: Sexual minority men experience disproportionately elevated rates of skin cancers, likely driven by excess ultraviolet radiation exposure-namely through tanning behaviors. However, limited integrated theoretical models exist to explain sexual minority men's elevated skin cancer risk. The aim of the current study is to further test and refine an integrated theory of skin cancer risk behaviors among sexual minority men by incorporating minority stress into the integrated health behavior model of tanning. METHOD: The study employed a parallel mixed methods design, with a Phase 1 qualitative stage (N = 30) and a Phase 2 quantitative stage (Model 1: N = 320; Model 2: N = 319). In both phases, participants were sexual minority men, equally stratified as those with versus without recent tanning exposure and were recruited from across the United States. RESULTS: Qualitative and quantitative data supported the overall integrated model, with some quantitative paths varying depending on the tanning behavior outcome. Overall, appearance-related motives to tan and beliefs that tanning regulates affect emerged as the most consistent proximal predictors. Minority stress significantly predicted holding more positive attitudes toward tanning as an effective affect regulation strategy. CONCLUSIONS: The results from this mixed methods study support the inclusion of minority stressors into the adapted integrative health behavior model of tanning. Replication within prospective designs would strengthen the evidence for this model, which may be helpful in guiding future skin cancer prevention programs tailored to sexual minority men. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Minorias Sexuais e de Gênero , Neoplasias Cutâneas , Banho de Sol , Humanos , Masculino , Minorias Sexuais e de Gênero/psicologia , Neoplasias Cutâneas/prevenção & controle , Adulto , Banho de Sol/psicologia , Adulto Jovem , Pessoa de Meia-Idade , Estados Unidos , Estresse Psicológico/psicologia , Assunção de Riscos , AdolescenteRESUMO
BACKGROUND: Indoor tanning is a preventable risk factor for skin cancer. Statewide shutdowns during the COVID-19 pandemic resulted in temporary closures of tanning businesses. Little is known about how tanners reacted to losing access to tanning businesses. OBJECTIVE: This study aimed to analyze Twitter (subsequently rebranded as X) chatter about indoor tanning during the statewide pandemic shutdowns. METHODS: We collected tweets from March 15 to April 30, 2020, and performed a directed content analysis of a random sample of 20% (1165/5811) of tweets from each week. The 2 coders independently rated themes (κ=0.67-1.0; 94%-100% agreement). RESULTS: About half (589/1165, 50.6%) of tweets were by people unlikely to indoor tan, and most of these mocked tanners or the act of tanning (562/589, 94.9%). A total of 34% (402/1165) of tweets were posted by users likely to indoor tan, and most of these (260/402, 64.7%) mentioned missing tanning beds, often citing appearance- or mood-related reasons or withdrawal. Some tweets by tanners expressed a desire to purchase or use home tanning beds (90/402, 22%), while only 3.9% (16/402) mentioned tanning alternatives (eg, self-tanner). Very few tweets (29/1165, 2.5%) were public health messages about the dangers of indoor tanning. CONCLUSIONS: Findings revealed that during statewide shutdowns, half of the tweets about indoor tanning were mocking tanning bed users and the tanned look, while about one-third were indoor tanners reacting to their inability to access tanning beds. Future work is needed to understand emerging trends in tanning post pandemic.
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BACKGROUND: Rates of melanoma have increased dramatically in the United States over the past 25 years, and it has become among the most prevalent cancers for young adult women. Intentional skin tanning leads to a pattern of intense and intermittent UV radiation exposure that is associated with increased risk of melanoma. Frequent tanning is most common among young women and is linked to a variety of sociocultural pressures that negatively impact body image and drive appearance control behaviors. Unfortunately, there are no established interventions designed for frequent tanners. This intervention addresses this gap with unique content informed by body image and acceptance-based interventions. The intervention is delivered using Facebook secret groups, an approach designed to support behavior change and ensure scalability. OBJECTIVE: This study aims to describe the rationale and methodology of a randomized controlled trial of a melanoma prevention program targeting young women engaged in frequent indoor or outdoor UV tanning. METHODS: Participants are women aged 18-25 years who report high-risk tanning (ie, at least 10 indoor tanning sessions in the past 12 months or 10 outdoor sessions in the previous summer). After recruitment and screening, participants completed a baseline survey and were randomly assigned to receive the intervention or an attention-matched control condition. Both conditions were 8-week-long Facebook groups (approximately 25 members each) with daily posting of content. Follow-up surveys are administered at 3, 8, and 18 months after baseline. The primary trial outcome is the combined number of indoor and outdoor tanning sessions reported at the 8-month follow-up. Hypothesized intervention mediators are assessed at the 3-month follow-up. RESULTS: This project was funded by a National Cancer Institute award (R01 CA218068), and the trial procedures were approved by the University of Kentucky Institutional Review Board in February 2020. Trial recruitment and enrollment occurred in 6 waves of data collection, which started in February 2022 and closed in May 2023. The study is closed to enrollment but remains open for follow-ups, and this protocol report was prepared before data analyses. As of February 2024, all participants have completed the 8-month follow-up assessment, and data collection is scheduled to close by the end of 2024 after the collection of the 18-month follow-up. CONCLUSIONS: This trial will contribute unique knowledge to the field of skin cancer prevention, as no fully powered trials have examined the efficacy of an intervention designed for frequent indoor or outdoor tanning. The trial may also contribute evidence of the value in translating principles of body image and acceptance-based interventions into the field of skin cancer prevention and beyond. If successful, the use of the Facebook platform is intended to aid in dissemination as it provides a way to embed the intervention into individuals' everyday routines. TRIAL REGISTRATION: ClinicalTrials.gov NCT03441321; https://clinicaltrials.gov/study/NCT03441321. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/56562.
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OBJECTIVE: To examine sources and perceived credibility of child nutrition information by maternal health literacy. METHODS: US mothers of children (0-12 years) who used social media regularly (N = 340) completed an online survey. Health literacy was assessed using the Newest Vital Sign. Child nutrition information sources and perceived credibility of sources were compared by health literacy using logistic and quantile regression models. RESULTS: Seventeen percent of mothers had limited health literacy. Compared to mothers with adequate health literacy, those with limited health literacy were more likely to get child nutrition information from siblings, extended family, dietitians, doctors, nurse practitioners, or physician assistants, and government agencies, and less likely to get information from Facebook. Mothers with limited health literacy rated information from parents, friends, Facebook, and Instagram as more credible than mothers with adequate health literacy. While perceived credibility of information from doctors, nurse practitioners, or physician assistants was high overall, mothers with limited health literacy perceived information from these health care providers as less credible. CONCLUSIONS: Sources of child nutrition information and perceived credibility differ by maternal health literacy. PRACTICE IMPLICATIONS: Pediatric providers are encouraged to refer parents to engaging resources that provide evidence-based child nutrition information.
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Letramento em Saúde , Nutricionistas , Mídias Sociais , Feminino , Humanos , Criança , Mães , Inquéritos e QuestionáriosRESUMO
Mobile technology growth in Nepal offers promising opportunities for using mobile health (mHealth) interventions to facilitate HIV prevention efforts. However, little is known about access and utilization of communication technology and their willingness to use mHealth for HIV prevention services in Nepal. We conducted a cross-sectional respondent-driven sampling survey of 250 MSM in Kathmandu Valley of Nepal from October to December 2022. We collected information on participant characteristics, HIV risk-related behaviors, ownership, or access to and frequency of use of communication technology (phones, tablets, laptops, and computers), and willingness to use mHealth to access HIV prevention services. Descriptive, bivariate, and multivariate linear regression analyses were performed. Almost all participants had smartphones with the internet (231/250, 92.4%) and accessed the internet daily (219/250, 87.6%) on the smartphone (236/250, 94.4%). The median score for willingness to use mHealth for HIV prevention was 10 (IQR: 3 to 17). Willingness to use mHealth was higher among those participants with a high school or above education (ß = 0.223, p = < 0.001), had experienced violence (ß = 0.231, p = 0.006), and had moderate to severe depressive symptoms (ß = 0.223, p = < 0.001). However, monthly income above NPR 20,000 (USD 150) (ß= -0.153, p = 0.008), disclosure of their sexual orientation to anyone (ß= -0.159, p = < 0.007), and worry about being negatively judged by health care workers (ß= -0.136, p = 0.023) were less willing to use mHealth strategies. The findings from this study suggest that there is a high willingness for utilizing mHealth interventions for HIV prevention in MSM population who are at higher risk of HIV acquisition.
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Infecções por HIV , Homossexualidade Masculina , Telemedicina , Humanos , Masculino , Nepal , Infecções por HIV/prevenção & controle , Adulto , Estudos Transversais , Homossexualidade Masculina/estatística & dados numéricos , Homossexualidade Masculina/psicologia , Adulto Jovem , Adolescente , Pessoa de Meia-IdadeRESUMO
PURPOSE: Adults with subjective cognitive decline (SCD), the self-reported concern of reduced cognitive function, are recommended to do physical activity for its brain health benefits. US adults aged ≥45 with SCD are less likely to meet the American College of Sports Medicine (ACSM) aerobic activity recommendations. Their engagement in muscle-strengthening activities is unknown. We aimed to identify if US adults aged ≥45 with SCD are less likely to do twice-weekly muscle-strengthening activities compared to those without SCD. DESIGN: Secondary analysis of the 2019 Behavioral Risk Factor Surveillance System (BRFSS) data. SAMPLE: 114 164 respondents, representing approximately 59 million US adults aged ≥45. MEASURES: SCD was indicated if the respondent reported confusion or memory loss during the past 12 months (yes/no). Respondents reported the frequency of muscle-strengthening activities, which we categorized as meeting the ACSM's recommendations (2+ times per week) or not (<2 times per week). ANALYSIS: Crude and adjusted logistic regression models controlling for variables associated with SCD and muscle-strengthening activities. The models used sample weights to represent US adults in the included 31 states and Washington D.C. RESULTS: US adults aged ≥45 with SCD were less likely to do twice-weekly muscle-strengthening activities than those without SCD (28.6% [SE: .8%] vs 33.5% [SE: .3%], adjusted OR, .9; 95% CI: .9-1.0). CONCLUSION: Primary care providers should encourage middle-aged and older patients to engage in muscle-strengthening and aerobic activities.
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Sistema de Vigilância de Fator de Risco Comportamental , Disfunção Cognitiva , Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Estados Unidos , Exercício Físico , Treinamento ResistidoRESUMO
Objective: Older adults may be particularly interested in health-related content on Facebook, especially those who have chronic health conditions. The purpose of this study was to compare older adult Facebook users with and without a chronic health condition on their frequency of posting and exposure to health-related content. Methods: Participants, recruited via Qualtrics, were regular Facebook users aged 50 + years. Participants were asked separately if they had seen, posted, and shared: Health-related information; about others'/their own health behaviors (e.g., exercise); and about others'/their own medical condition. Six logistic regression models, controlling for demographics and Facebook login frequency, were run to assess whether viewing and/or posting health-related messages differed by chronic health condition status. Results: Respondents (N = 697; 77.9% female) were on average 61.2 (SD = 7.9) years old and (n = 625; 89.7%) were White. One-half reported a chronic health condition (n = 351; 50.4%). In adjusted models, those with a chronic health condition had a higher likelihood of seeing posts containing health information (OR = 1.41; 95% CI: 1.04, 1.93) and about others' medical conditions (OR = 1.67; 95% CI: 1.22, 2.27) at least once a month compared to those with no chronic health conditions. People with and without chronic health conditions did not differ in terms of how often they see others' post about health behaviors. Those with a chronic health condition had a higher likelihood of posting or sharing health information (OR = 1.67; 95% CI: 1.22, 2.27), posting about their own health behaviors (OR = 1.55; 95% CI: 1.00, 2.44; p = 0.048), and about their health condition (OR = 1.96; 95% CI: 1.17, 3.27) at least once a month. Conclusion: Most older adults on Facebook are exposed to and post multiple forms of health-related content. Therefore, Facebook may be an appropriate channel for conducting health-related communication targeting older adults.
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BACKGROUND: About 59%-73% of Black women do not meet the recommended targets for physical activity (PA). PA is a key modifiable lifestyle factor that can help mitigate risk for chronic diseases such as obesity, diabetes, and hypertension that disproportionately affect Black women. Web-based communities focused on PA have been emerging in recent years as web-based gathering spaces to provide support for PA in specific populations. One example is Black Girls Run (BGR), which is devoted to promoting PA in Black women. OBJECTIVE: The purpose of this study was to describe the content shared on the BGR public Facebook page to provide insight into how web-based communities engage Black women in PA and inform the development of web-based PA interventions for Black women. METHODS: Using Facebook Crowdtangle, we collected posts (n=397) and associated engagement data from the BGR public Facebook page for the 6-month period between June 1, 2021, and December 31, 2021. We pooled data in Dedoose to analyze the qualitative data and conducted a content analysis of qualitative data. We quantified types of posts, post engagement, and compared post types on engagement: "like," "love," "haha," "wow," "care," "sad," "angry," "comments," and "shares." RESULTS: The content analysis revealed 8 categories of posts: shout-outs to members for achievements (n=122, 31%), goals or motivational (n=65, 16%), announcements (n=63, 16%), sponsored or ads (n=54, 14%), health related (n=47, 11%), the lived Black experience (n=23, 6%), self-care (n=15, 4%), and holidays or greetings (n=8, 2%). The 397 posts attracted a total of 55,354 engagements (reactions, comments, and shares). Associations between the number of engagement and post categories were analyzed using generalized linear models. Shout-out posts (n=22,268) elicited the highest average of total user engagement of 181.7 (SD 116.7), followed by goals or motivational posts (n=11,490) with an average total engagement of 160.1 (SD 125.2) and announcements (n=7962) having an average total engagement of 129.9 (SD 170.7). Significant statistical differences were found among the total engagement of posts (χ72=80.99, P<.001), "like" (χ72=119.37, P<.001), "love" (χ72=63.995, P<.001), "wow" (χ72=23.73, P<.001), "care" (χ72=35.06, P<.001), "comments" (χ72=80.55, P<.001), and "shares" (χ72=71.28, P<.001). CONCLUSIONS: The majority of content on the BGR Facebook page (n=250, 63%) was focused on celebrating member achievements, motivating members to get active, and announcing and promoting active events. These types of posts attracted 75% of total post engagement. BGR appears to be a rich web-based community that offers social support for PA as well as culturally relevant health and social justice content. Web-based communities may be uniquely positioned to engage minoritized populations in health behavior. Further research should explore how and if web-based communities such as BGR can be interwoven into health interventions and health promotion.
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OBJECTIVE: The aim of this study was to explore health perceptions and self-defined facilitators to health in general population. An additional aim of the study was to assess if these perceptions were connected with the context of the Covid-19 pandemic. DESIGN: We applied photo-elicitation method by gathering original photographs and narratives (captions) via social media and e-mails. Participants (N = 50) were asked to answer the question: 'What does it mean to be healthy?'. Data were collected online in Poland. We generated and interpreted the main themes associated with common perceptions of health and self-defined facilitators to health using polytextual thematic analysis. RESULTS: The health perception themes were, health as: a 'long journey'; keeping balance; and self-acceptance. The main facilitators to health were: enjoyment of activities that are part of a healthy lifestyle; planning time for rest; contact with nature, and supportive relationships. Participants' perceptions of how Covid-19 impacted on their health differed. CONCLUSIONS: The findings provide evidence for individual health perceptions and self-defined facilitators to health and can support the development of future health interventions.
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Introduction: Indoor tanning beds cause more than 450,000 new skin cancers each year, yet their use remains common, with a global indoor tanning prevalence of 10.4%. Social media provides an opportunity for cost-effective, targeted public health messaging. We sought to direct Instagram users at high risk of indoor tanning to accurate health information about the risks of indoor tanning and to reduce indoor tanning bed use. Methods: We disseminated a public health campaign on Instagram on April 6-27, 2022 with 34 video and still-image advertisements. We had 2 target audiences at high risk of indoor tanning: women aged 18-30 years in Kentucky, Nebraska, Ohio, or Tennessee interested in indoor tanning and men aged 18-45 years in California interested in indoor tanning. To evaluate the impact of the campaign, we tracked online metrics, including website visits, and conducted an interrupted time-series analysis of foot traffic data in our target states for all tanning salons documented on SafeGraph from January 1, 2018 to 3 months after the campaign. Results: Our indoor tanning health information advertisements appeared on Instagram feeds 9.1 million times, reaching 1.06 million individuals. We received 7,004 views of our indoor tanning health information landing page (Average Time on Page of 56 seconds). We did not identify a significant impact on foot traffic data on tanning salons. Conclusions: We show the successful use of social media advertising to direct high-risk groups to online health information about indoor tanning. Future research quantifying tanning visits before and after indoor tanning interventions is needed to guide future public health efforts.
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Increasing understanding of the risk and protective factors for adolescent nonmedical use of prescription drugs (NMUPD) could inform prevention efforts. Several correlates have been identified, including parental factors, perceptions about use and accessibility, social norms, and age. However, these constructs have rarely been simultaneously examined using paired data from parents and adolescents. We aimed to examine the relative influence of these correlates among dyads (N=349) of mothers and adolescent daughters. Using multiple logistic regression, daughters' past NMUPD and inclination for future NMUPD were regressed onto descriptive norms for friend use, perceived drug accessibility and risk of harm from use, daughter age, mothers' disapproval about use, mothers' past NMUPD and inclination for future NMUPD, and the mother-daughter relationship quality. Akaike weights and lasso regressions were also estimated to evaluate the relative importance of each correlate. Higher descriptive norms for friend use, older age, and mothers' inclination for NMUPD were risk factors for daughters' NMUPD, while a closer mother-daughter relationship and mothers' disapproving attitudes towards NMUPD were protective factors. The three analysis approaches were corroborative. Results suggest friend descriptive norms, mother-daughter relationship quality, and mothers' attitudes about NMUPD are important prevention targets.
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BACKGROUND: Digital behavioral weight loss programs are scalable and effective, and they provide an opportunity to personalize intervention components. However, more research is needed to test the acceptability and efficacy of personalized digital behavioral weight loss interventions. OBJECTIVE: In a 6-month single-arm trial, we examined weight loss, acceptability, and secondary outcomes of a digital commercial weight loss program (WeightWatchers). This digital program included a personalized weight loss program based on sex, age, height, weight, and personal food preferences, as well as synchronous (eg, virtual workshops and individual weekly check-ins) and asynchronous (eg, mobile app and virtual group) elements. In addition to a personalized daily and weekly PersonalPoints target, the program provided users with personalized lists of ≥300 ZeroPoint foods, which are foods that do not need to be weighed, measured, or tracked. METHODS: We conducted a pre-post evaluation of this 6-month, digitally delivered, and personalized WeightWatchers weight management program on weight loss at 3 and 6 months in adults with overweight and obesity. The secondary outcomes included participation, satisfaction, fruit and vegetable intake, physical activity, sleep quality, hunger, food cravings, quality of life, self-compassion, well-being, and behavioral automaticity. RESULTS: Of the 153 participants, 107 (69.9%) were female, and 65 (42.5%) identified as being from a minoritized racial or ethnic group. Participants' mean age was 41.09 (SD 13.78) years, and their mean BMI was 31.8 (SD 5.0) kg/m2. Participants had an average weight change of -4.25% (SD 3.93%) from baseline to 3 months and -5.05% (SD 5.59%) from baseline to 6 months. At 6 months, the percentages of participants who experienced ≥3%, ≥5%, and ≥10% weight loss were 63.4% (97/153), 51% (78/153), and 14.4% (22/153), respectively. The mean percentage of weeks in which participants engaged in ≥1 aspects of the program was 87.53% (SD 23.40%) at 3 months and 77.67% (SD 28.69%) at 6 months. Retention was high (132/153, 86.3%), and more than two-thirds (94/140, 67.1%) of the participants reported that the program helped them lose weight. Significant improvements were observed in fruit and vegetable intake, physical activity, sleep quality, hunger, food cravings, quality of life, and well-being (all P values <.01). CONCLUSIONS: This personalized, digital, and scalable behavioral weight management program resulted in clinically significant weight loss in half (78/153, 51%) of the participants as well as improvements in behavioral and psychosocial outcomes. Future research should compare personalized digital weight loss programs with generic programs on weight loss, participation, and acceptability.
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Terapia Comportamental , Qualidade de Vida , Adulto , Feminino , Humanos , Masculino , Etnicidade , Exercício Físico , FrutasRESUMO
Six years ago, we published a paper describing the Society of Behavioral Medicine's (SBM) health policy organizational leadership structure and policy initiatives. The purpose of the current paper is to provide an update on changes in the infrastructure and new policy initiatives that have been developed since 2017. We review each of the policy leadership arms of SBM including details of the work of each and goals for the future. The SBM engages in several health policy advocacy efforts through their Advocacy Council and Position Statements Committee. The Advocacy Council launched the Health Policy Ambassador Program in 2020. The Ambassador Program serves to train members to develop longer-term relationships with legislative staff around key policy priority areas. The Position Statements Committee is responsible for overseeing the development and dissemination of health policy position statements. Both groups work together and with partner organizations to increase the impact of our science. Over the last 6 years, developing a stronger infrastructure and implementing metrics for progress such as tracking social media engagement has helped to move SBM's policy agenda forward. The work of the policy-related leadership teams can serve as a model for other organizations who are interested in further developing their policy advocacy efforts.
The Society of Behavioral Medicine (SBM) engages in several health policy advocacy efforts through their Advocacy Council and Position Statements Committee. The Advocacy Council launch the Health Policy Ambassador Program in 2020. The Ambassador Program serves to train members to develop longer-term relationships with legislative staff around key policy priority areas. The Position Statements Committee is responsible for overseeing the development and dissemination of health policy position statements. Both groups work together and with partner organizations to increase the impact of our science. Over the last 6 years, developing a stronger infrastructure and implementing metrics for progress has helped to move SBM's policy agenda forward. The work of the policy-related leadership teams can serve as a model for other organizations who are interested in further developing their policy advocacy efforts.
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Medicina do Comportamento , Humanos , Sociedades , Política de SaúdeRESUMO
BACKGROUND: Digitization (using novel digital tools and strategies) and consumerism (taking a consumer-oriented approach) are increasingly commonplace in clinical trials, but the implications of these changes are not well described. METHODS: We assembled a group of trial experts from academia, industry, non-profit, and government to discuss implications of this changing trial landscape and provide guidance. RESULTS: Digitization and consumerism can increase the volume and diversity of trial participants and expedite recruitment. However, downstream bottlenecks, challenges with retention, and serious issues with equity, ethics, and security can result. A "click and mortar" approach, combining approaches from novel and traditional trials with the thoughtful use of technology, may optimally balance opportunities and challenges facing many trials. CONCLUSION: We offer expert guidance and three "click and mortar" approaches to digital, consumer-oriented trials. More guidance and research are needed to navigate the associated opportunities and challenges.
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OBJECTIVE: The aim of this study was to identify the levels of food-tracking adherence that best predict ≥3%, ≥5%, and ≥10% weight loss at 6 months and to identify distinctive food-tracking trajectories among participants in a 6-month, commercial digital weight-management program. METHODS: This study used data from 153 participants of a single-arm trial of a commercial digital weight-management program, WeightWatchers (WW). Receiver operating characteristic (ROC) curve analysis was conducted to identify the optimum thresholds of food tracking that can predict ≥3%, ≥5%, and ≥10% weight loss at 6 months. Time series clustering analysis was performed on weekly food-tracking data to identify trajectories and compare trajectories on weight loss at 6 months. RESULTS: ROC analyses showed that the optimum thresholds of food tracking were 28.5% of the intervention days to achieve ≥3% weight loss (area under the curve [AUC] = 0.820, p < 0.001), 39.4% to achieve ≥5% weight loss (AUC = 0.744, p < 0.001), and 67.1% to achieve 10% weight loss (AUC = 0.712, p = 0.002). Time series clustering analyses found three food-tracking trajectories. Trajectories differed significantly in weight loss at 6 months (F = 14.1, p < 0.001). CONCLUSIONS: Results suggest that perfect food-tracking adherence is not necessary to achieve clinically significant weight loss.
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Programas de Redução de Peso , Humanos , Terapia Comportamental , Alimentos , Projetos de Pesquisa , Redução de Peso , Programas de Redução de Peso/métodosRESUMO
The World Health Organization (WHO) defines an infodemic as the proliferation of false or misleading information that leads to confusion, mistrust in health authorities, and the rejection of public health recommendations. The devastating impacts of an infodemic on public health were felt during the COVID-19 pandemic. We are now on the precipice of another infodemic, this one regarding abortion. On June 24, 2022, the Supreme Court of the United States (SCOTUS) decision in Dobbs v. Jackson Women's Health Organization resulted in the reversal of Roe v. Wade, which had protected a woman's right to have an abortion for nearly 50 years. The reversal of Roe v. Wade has given way to an abortion infodemic that is being exacerbated by a confusing and rapidly changing legislative landscape, the proliferation of abortion disinformants on the web, lax efforts by social media companies to abate abortion misinformation, and proposed legislation that threatens to prohibit the distribution of evidence-based abortion information. The abortion infodemic threatens to worsen the detrimental effects of the Roe v. Wade reversal on maternal morbidity and mortality. It also comes with unique barriers to traditional abatement efforts. In this piece, we lay out these challenges and urgently call for a public health research agenda on the abortion infodemic to stimulate the development of evidence-based public health efforts to mitigate the impact of misinformation on the increased maternal morbidity and mortality that is expected to result from abortion restrictions, particularly among marginalized populations.
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Aborto Induzido , COVID-19 , Gravidez , Feminino , Estados Unidos , Humanos , Aborto Legal , Infodemia , PandemiasRESUMO
Background: Excessive gestational weight gain is associated with negative maternal and infant health outcomes. Digital health approaches may help overcome barriers to participating in lifestyle interventions requiring in-person visits. The purpose of this study was to develop and examine the feasibility of a web-based gestational weight gain intervention. Methods: Intervention development included feedback and input from pregnant women. We conducted a 12-week one-arm pilot study during which participants engaged in an online discussion board with coaches and other pregnant women, tracked their weight gain with an interactive graph, and accessed a list of online resources for pregnancy health. Feasibility outcomes were recruitment, retention, engagement and sustained participation, intervention acceptability, and website usability. Gestational weight gain was an exploratory outcome. Results: Participants (n=12) were on average 16.8 [standard deviation (SD): 2.0] weeks gestation with average pre-pregnancy body mass index of 30.5 (SD: 4.8) kg/m2. Participant retention was 92% (n=11). Participants logged into the website a median of 21 times [interquartile range (IQR), 8-37; range, 2-98] over 12 weeks, and 58% (n=7) logged into the website during the last week of the intervention. All participants said they would be very likely or likely to participate again, and 100% said they would be very likely or likely to recommend the intervention to a pregnant friend. In post-intervention interviews, 64% (n=7) explicitly said that the website was easy to use, but 100% (n=11) mentioned usability issues. When asked their preferred intervention platform, 18% (n=2) somewhat or strongly preferred a private website, 18% (n=2) had no preference, and 64% (n=7) somewhat or strongly preferred Facebook. Seventy percent (n=7) had excessive gestational weight gain, 10% (n=1) inadequate gestational weight gain, and 20% (n=2) gained within recommended ranges. Conclusions: Additional development work is needed before moving to efficacy testing. Most notably, usability issues with the investigator-developed website and participant preference suggest a switch to a commercial social media platform.